Is Time-Restricted Eating Better Than Other Diets?

Is Time-Restricted Eating Right For You?

Author: Dr. Stephen Chaney 

Time-restricted eating is the latest fad. If you read Dr. Strangeloves’ blogs, he or she will tell you that eating for 8-10 hours and fasting the rest of the day will change your metabolism. They tell you that:

  • You don’t need to change what you eat.
  • You don’t have to restrict calories.
  • You don’t have to restrict fats or carbs.
  • You will feel fuller and naturally eat less.
  • The pounds will just drop away magically.

And you will have benefits like:

  • Better blood sugar control.
  • Lower levels of heart-unhealthy lipids like LDL and triglycerides.
  • Enhanced cellular repair, which might help you live longer.

Are these claims true? Is there something special about time-restricted eating, or is it simply another way to cut calories?

Two recent studies (EA Thomas et al, Obesity; 30: 1027-1038, 2022) and (D Liu et al, New England Journal of Medicine, 386: 1495-1505, 2023) answered these questions by cutting calories to the same extent for people following a time-restricted eating pattern and people who had no restrictions on when they ate.

How Were These Studies Done?

clinical studyStudy 1: The authors enrolled 81 adults aged 18 to 50 years (average = 38 years, 69% female) with BMIs of 27 to 45 (overweight to morbidly obese).

The study lasted 39 weeks with measurements taken at baseline, 12 weeks, and 39 weeks.

The participants were divided into two groups:

  • A time-restricted eating group that was advised to restrict their eating to start eating within 3 hours of waking and restrict their eating to 10 hours.
  • A calorie restricted group that was given no time limitations on when they could eat.

Both groups were:

  • given a personalized calorie goal which represented a 35% caloric restriction based on measurements of their resting energy expenditure.
  • enrolled in a 39-week, group-based, comprehensive weight-loss program. Groups were taught by registered dietitians and met weekly through the first 12 weeks, and monthly between weeks 13 and 39.

Study 2: The authors enrolled 139 adults 18 to 75 years (average age = 32, 64% female) with BMIs of 28 to 45. The study lasted 12 months.

The participants were divided into two groups:

  • A time-restricted eating group that was advised to restrict their eating to between 8 AM and 4 PM (an 8-hour window) each day.
  • A calorie restricted group that was given no time limitations on when they could eat.

Both groups:

  • Were told to reduce calories by 25% which represented a 1500-1800 calorie/day diet for men and a 1200-1500 calorie/day diet for women.
  • Received dietary information booklets that provided portion advice and sample menus.
  • Were required to write in a daily dietary log, photograph the food they ate, and note the time they ate it using a mobile app.
  • Received follow up phone calls or app messages twice per week and met with trained health coaches every two weeks.

Is Time Restricted Eating Better Than Other Diets?

Here are the results of the two studies.

Study 1: There was no difference between the time-restricted group and the group who were just told to cut calories at either 12 or 39 weeks for:

  • Weight loss.
  • Body composition (fat loss and lean muscle mass loss).
  • Appetite and eating behaviors.
  • HDL cholesterol, LDL cholesterol, total cholesterol, and HbA1c (a measure of blood sugar control).

The authors concluded two things:

  1. “Time-restricted eating with caloric restriction was found to be an acceptable dietary strategy, resulting in similar levels of adherence and weight loss compared to caloric restriction alone.”

2) “The addition of behavioral support and caloric restriction to a time-restricted eating intervention results in a clinically significant weight loss, a reduction in caloric input, and an improvement in diet quality.”

Study 2: There was no difference between the time-restricted group and the group who were just told to cut calories at 12 months for:

  • Weight loss, BMI, and waist circumference.
  • Body composition (fat loss and lean muscle mass loss).
  • Appetite and eating behaviors.
  • Blood pressure, HDL cholesterol, LDL cholesterol, total cholesterol, fasting blood sugar levels, and several measures of blood sugar control.

The authors concluded, “Among patients with obesity, a regimen of time-restricted eating was not more beneficial with regard to reduction in body weight, body fat, or metabolic risk factors than daily caloric restriction.”

Is Time-Restricted Eating Right For You?

Questioning WomanThe take-home lessons are the same for both studies.

  1. You can forget the metabolic mumbo-jumbo of the Dr. Strangeloves of our world. When you restrict calories to the same extent, time-restricted eating is no more successful and no healthier than any other diet.”

2) Like any other diet, time-restricted eating works best when you focus on eating healthy foods and reducing your caloric intake.

So, what does this mean for you? I have two thoughts:

1) If you find it easier to cut calories by restricting the time you eat, then time-restricted eating is right for you. If not, choose a healthy, reduced calorie diet that best fits your food preferences and lifestyle.

2) Time-restricted eating works best when you are in complete control of when and what you eat. They don’t work as well for travel, holidays with friends and family, and other social occasions. If your lifestyle is such that you are often not in control of when and what you eat, you might want to choose a more flexible diet.

The Bottom Line 

Time-restricted eating is the latest fad. If you read Dr. Strangeloves’ blogs, he or she will tell you that eating for 8-10 hours and fasting the rest of the day will change your metabolism, the weight will fall away effortlessly, and your health will be better.

But is this true? Two recent studies tested the hypothesis that time-restricted eating offers a special advantage by cutting calories to the same extent for people following a time-restricted eating pattern and people who had no restrictions on when they ate.

Both studies found there was no difference between the time-restricted group and the group who were just told to cut calories for:

  • Weight loss.
  • Body composition (fat loss and lean muscle mass loss).
  • Appetite and eating behaviors.
  • HDL cholesterol, LDL cholesterol, total cholesterol, and HbA1c (a measure of blood sugar control).

The take-home lessons are the same for both studies.

  1. You can forget the metabolic mumbo-jumbo of the Dr. Strangeloves of our world. When you restrict calories to the same extent, time-restricted eating is no more successful and no healthier than any other diet.”

2) Like any other diet, time-restricted eating works best when you focus on eating healthy foods and reducing your caloric intake.

For more information on this study and a discussion of whether time-restricted eating might be right for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 ___________________________________________________________________________

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My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

Does Intermittent Fasting Work?

Will Intermittent Fasting Help You Lose Weight?

Author: Dr. Stephen Chaney

intermittent fastingIf you are like millions of Americans, one of your New Year’s resolutions is to lose weight. Now your dilemma is how to accomplish that. You have tried various diets before – Atkins, paleo, keto, Whole 30, etc. You lost some weight, but it came right back. You are looking for something new, something different from anything you have tried before.

What about intermittent fasting? It’s hot right now. It’s probably different from what you have tried in the past. It doesn’t require radical changes to what you eat. Some of your friends are singing its praises. Could this be the one that solves your weight problem forever?

A Primer On Intermittent Fasting

professor owlLet’s start by defining intermittent fasting and reviewing what we already know about it. There are several variations of what the mass media refers to as intermittent fasting, but the two most popular versions are:

  • Time-restricted fasting which limits daily intake of food to a 4 to 12-hour period. The most popular version of this restricts food intake to 8 hours followed by 16 hours of fasting.
  • Intermittent fasting in which there is a day or more of fasting or decreased food intake between periods of unrestricted eating. The most popular version of this allows 5 days of unrestricted eating followed by 2 days of fasting.

A major review (Di Francesco et al, Science, 362: 770-775, 2018) of time-restricted and intermittent fasting was published a little over a year ago. At the time that review was published, there were lots of studies comparing time-restricted fasting with continuous caloric restriction. I summarized those findings in a previous issue of “Health Tips From the Professor” last January.

Here is a brief summary of the key findings from that review:

  • If you read the blogs about time-restricted fasting, you will come across all sorts of metabolic mumbo-jumbo about ketone bodies, adiponectin, leptin, IGF-1, and blood glucose levels. It sounds so convincing. Don’t get sucked in by these pseudo-scientific explanations. At this point they are mostly speculation.
  • Although there is no conscious effort to control calories, time-restricted fasting result in an inadvertent reduction in food intake by restricting the time allowed for eating and by eliminating late night snacking. This reduction in caloric intake is likely responsible for most of the weight loss associated with intermittent fasting. When you control for calories, there is no difference in weight loss between time-restricted fasting and continuous caloric restriction (your typical reduced calorie diet).

However, at the time the review was published, far less was known about the relative benefits of intermittent fasting and simple caloric restriction. Since that time, two studies have rigorously compared the effectiveness of intermittent fasting and continuous caloric restriction on weight loss. I review those studies below

Will Intermittent Fasting Help You Lose Weight?

The first study (YM Roman et al, International Journal of Obesity, 43: 2017-2027, 2019) was a systematic review and meta-analysis of 9 clinical studies comparing intermittent fasting with continuous caloric restriction. Total caloric reduction was controlled and was the same for both intermittent fasting and continuous caloric reduction.

The studies ranged from 12 weeks to 52 weeks with most of them in the 20 to 30-week range. This meta-analysis found:

·       There was no difference between intermittent fasting and continuous caloric restriction in terms of weight loss, waist circumference, or body fat loss.

·       Loss of lean body mass, on the other hand, was greater for intermittent fasting than for continuous caloric restriction.

The authors concluded: “Since it is ultimately fat mass loss that improves health indices, and not the loss of muscle, the significantly greater loss of lean mass in the intermittent dieting group versus the continuous dieting group is concerning and needs to be further assessed.”

I would add, it is also concerning because lean mass muscle burns calories faster than fat mass. Loss of lean muscle mass could lead to a lower metabolic rate. That would make maintenance of the weight loss more difficult.

The second study (ML Headland et al, International Journal of Obesity, 43: 2028-2036) compared intermittent fasting versus continuous calorie restriction for 12 months in a group of 332 healthy overweight or obese adults. Again, total caloric reduction was the same for the two groups. In this study:

·       There was no significant difference between intermittent fasting and continuous caloric restriction for weight loss, body fat loss, and lean body mass loss. [Note: The retention of lean body mass in this study differs from the loss of lean body mass reported in the previous study. Additional studies will be required before we become overly concerned about potential loss of lean body mass with intermittent fasting.]

·       There were also no significant differences between the groups for blood levels of glucose, total cholesterol, triglycerides, HDL, and LDL.

Does Intermittent Fasting Work?

does intermittent fasting workThese studies make it clear there is no “magic” associated with either time-restricted or intermittent fasting.

·       If either time-restricted or intermittent fasting allows you to reduce your daily caloric intake by restricting the time that you are eating, you will lose weight and keep it off. However, if you compensate for the fasting periods by consuming additional calories when you are eating, all bets are off.

·       In clinical studies that restrict calories to the same extent in the various diets, neither time-restricted nor intermittent fasting results in greater weight loss than continuous caloric restriction (your typical reduced calorie diet).

o   In addition, neither time-restricted nor intermittent fasting results in better improvement in blood parameters (glucose, total cholesterol, triglycerides, HDL, and LDL) than continuous caloric restriction.

·       Intermittent fasting may result in greater loss of lean muscle mass than continuous caloric reduction. If confirmed by subsequent studies, this would be concerning.

This also means:

·       If you happen to read the blogs about time-restricted or intermittent fasting, you can forget all the metabolic mumbo-jumbo about ketone bodies, adiponectin, leptin, IGF-1, and blood glucose levels.

o   At this point this metabolic information comes mostly from animal studies. Its application to humans is purely speculation.

o   Since time-restricted and intermittent fasting offer no advantage over continuous caloric restriction, there is no evidence that changes in any of those metabolic markers has any effect on weight loss in humans.

Finally, you need to ask whether time-restricted and intermittent fasting are something you can maintain in the real world.

·       Your friends are unlikely to be on the same schedule. It won’t be easy to fit your diet around socializing, travel, and holidays.

The Bottom Line

There are several variations of what the mass media refers to as intermittent fasting, but the two most popular versions are:

  • Time-restricted fasting which limits daily intake of food to a 4 to 12-hour period. The most popular version of this restricts food intake to 8 hours followed by 16 hours of fasting.
  • Intermittent fasting in which there is a day or more of fasting or decreased food intake between periods of unrestricted eating. The most popular version of this allows 5 days of unrestricted eating followed by 2 days of fasting.

The latest studies make it clear there is no “magic” associated with either time-restricted or intermittent fasting.

·       If either time-restricted or intermittent fasting allows you to reduce your daily caloric intake by restricting the time that you are eating, you will lose weight and keep it off. However, if you compensate for the fasting periods by consuming additional calories when you are eating, all bets are off.

·       In clinical studies that restrict calories to the same extent in the various diets, neither time-restricted nor intermittent fasting results in greater weight loss than continuous caloric restriction (your typical reduced calorie diet).

o   In addition, neither time-restricted nor intermittent fasting results in better improvement in blood parameters (glucose, total cholesterol, triglycerides, HDL, and LDL) than continuous caloric restriction.

·       Intermittent fasting may result in greater loss of lean muscle mass than continuous caloric reduction. If confirmed by subsequent studies, this would be concerning.

Finally, you need to ask whether time-restricted and intermittent fasting are something you can maintain in the real world.

·       Your friends are unlikely to be on the same schedule. It won’t easy to fit your diet around socializing, travel, and holidays.

For more details, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

Health Tips From The Professor